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It’s imperative that all sections of society, especially the poor, are included in Malaysia’s National Covid-19 Vaccination Programme.

The coronavirus pandemic in Malaysia is worsening by the day, especially since the beginning of April. This is unsurprising given the country’s lackluster performance in combating the pandemic and the numerous policy flip-flops.

As of June 18 2021, the total number of infections stands at 685,204 and the death toll at 4,276. The record number of daily infections over the last four weeks is the primary cause of this cumulative figure – an unthinkable statistic a year ago. Our hospitals, medical facilities and medical personnel have reached breaking point, after almost sixteen months of battling the pandemic. That we have to act quickly, correctly and decisively is an understatement, especially if we wish to see that proverbial light at the end of the tunnel soon.

It is clear to most of us that the Movement Control Orders (MCOs) in their various forms have failed to stem the tide of this virus. The time has come for us to abandon the sluggish pandemic-fighting efforts, and instead rapidly execute a robust FFTIS (Find, Test, Trace, Isolate & Support) response, and speed up the vaccine rollout.

In this two-prong approach, there has to be inclusivity – bringing on board each and every Malaysian especially those living outside the cities. Most of these people have been largely forgotten in the fight against the pandemic. There has been no concerted effort to reach out to the poor especially in states like Sabah, Sarawak, Kelantan and Kedah where a significant number of the population live in villages, rural settlements, and isolated orang asli and orang asal settlements.

One must also not overlook the documented and undocumented foreign workers, some of whom live close to the jungles for fear of being caught. It’s worth remembering that migrant workers play a key role in determining if we arrive at a happily-ever-after in our Covid-19 story. Data released by the Ministry of Health points out that factories and construction sites where foreign workers are employed made up 48.06% and 11.56% respectively of the clusters formed in these places.

Little has been done to explain, enlighten and convince these communities on the dangers of the virus. Far less has been done to address the ignorance about Covid-19 or to remove doubts, misgivings and hesitancy about vaccines.

It is now important that the Health Ministry rope in other government agencies like FELDA, RISDA, JKK, RELA, the police and community organisations to reach out to all these groups, especially those living far away from the urban centres. These agencies can also play help to register the people in the rural and outlying areas for the vaccination exercise because these communities with their limited access to computers, smart phones, and the internet, cannot be expected to be fully aware of the vaccine rollout, much less register for the vaccine.

Picking up the pace

The failure to seriously and wholeheartedly address the issues of virus ignorance and vaccine heistancy has affected the registration exercise and the subsequent vaccination rollout, especially in the case of senior citizens. Otherwise how does one explain why only six million had registered for the vaccination up to March 21 (one month after registrations began), or why between March and early June the figures had increased to only 12.58 million or to 51.9% of the targeted population.

In early April even the Minister of Health had queried why only 7.6 million of the targeted 26.7 million had registered for vaccination. (As of June 18, the number of people registered for the vaccine stands at 15.07 million.)

The latest statistics show states such as Selangor, Negeri Sembilan and Sarawak being well ahead with more than 70% of their residents registered for the vaccination (and 99% and 100% respectively for KL and Putrajaya). In Sabah however, only 27% of the targeted population have signed up. Equally, although there have been improvements in recent weeks, the numbers in Kelantan, Pahang, Terengganu and Kedah where only about half the target population have registered for the vaccine is still a cause for concern.

STATISTICS FOR NATIONAL COVID-19 IMMUNISATION PROGRAMME

(updated 18 June 2021)

State	Registered	% of targeted population
Johor	1,879,963	69.32%
Kedah	881,415	57.21%
Kelantan	580,844	46.99%
Kuala Lumpur	1,353,069	100.00%
Labuan	52,170	76.16%
Melaka	475,477	70.19%
Negeri Sembilan	591,099	72.58%
Pahang	666,887	56.72%
Pulau Pinang	963,909	70.50%
Perak	1,077,643	57.85%
Perlis	115,835	63.93%
Putrajaya	75,350	100.00%
Sabah	777,211	28.18%
Sarawak	1,463,079	71.62%
Selangor	3,676,374	77.43%
Terengganu	442,454	54.73%

SOURCE : www.vaksincovid.gov.my

This slow pace of registration in the less developed states should have been quickened by allowing on-the-spot registration at vaccination centres and/or registrations at the penghulu, district, or FELDA offices. Even community centres, mosques, temples and JAKOA can be utilised for these purposes. The latter can act as Covid-19 information and registration offices for the orang asli communities, and the same offices can later display information about vaccine appointment dates.

The process of registration for vaccination could have been implemented almost seamlessly and the race towards achieving herd immunity accelerated. It’s been reported that as of now, the country needs to get at least another twelve million people to sign up for vaccination before the end of this year. Whether this can be done in the next five months under the prevailing conditions is a million dollar question because many people believe the app used in the vaccine rollout, MySejahtera, has “lost the plot”. The media is abuzz with complaints from people asked to go to vaccination centres hundreds of kilometres away from their homes. There are also many senior citizens in states like Selangor, Penang, Perak who have yet to receive appointments, despite having registered much earlier. There are also cases of those registering later but getting earlier appointments, while some are informed of their appointments at the 11^th hour. In short, MySejahtera has lost its way.

Another equally daunting task for the residents in the small towns and rural areas is keeping their vaccination appointments. As of May 27 52,000 people have missed their appointments. According to a news report, in Kedah 10,827 individuals or one-third of those registered did not turn up for their appointments. In Perlis, Pahang and Malacca almost 17,000 failed to show up for their vaccinations. The majority of these are senior citizens. The reasons for the no-shows were vaccination centres being far from their homes, problems in going to the vaccination centres, failing to check their appointment dates and lastly, that no one was around to take them to the vaccination centres. Some could have even been influenced by negative news about the vaccines. So, the figures above speak volumes about the predicament we are in now.

In order to ensure a higher level of attendance, the authorities must consider options such as vaccination booths at low cost flats, housing estates, factories, construction sites, mosques, mobile vaccination centres and even drive by centres. These measures besides speeding up the numbers getting vaccinated, are also convenient, cheap, time saving and above all safe. Let us remember that desperate times call for desperate measures. So, even unconventional methods of getting people vaccinated should not be ruled out. We could even liken the situation to one where “if Mohammad doesn’t go to the mountain, then the mountain will have to come to Mohammad”.

The talk of taking punitive action against those who fail to turn up for vaccination, such as fines or charging them in court will only worsen matters. Even a carrot-stick approach may not be so successful. In the case of undocumented migrant workers and their dependents the law and law enforcement must suspend all legal action, and instead take all possible measures to bring them out of their hideouts for testing and follow up treatments. They should also be included in the vaccination programme. Any attempt to do otherwise will spell doom for our Covid-19 fighting efforts.

The national vaccination programme hinges on those behind the rollout to inform, enlighten, convince and ultimately create trust among the population. The latter, in particular, needs to be the guiding principle.

No interuptions to vaccine supply

Last but not least, is the very critical question of whether we will have enough vaccines to vaccinate 27.5 million people (or more, if we include those aged 12-18) by the end of the year. One of principal reasons why the vaccination programme slowed down soon after it began with much fanfare was because we ran short of vaccines, with the promised vaccines not having arrived. This happened partly because we were late in venturing into the vaccine market. Our negotiations with the vaccine manufacturers did not take off much earlier. On the other hand, countries such as Japan and Singapore had made arrangements to procure their vaccines much earlier. Consequently, we were not able to secure our supplies at the right time and in the desired quantities.

But now the situation seems to have altered. It’s been reported that 2.2 million doses of Pfizer’s coronavirus vaccie are due in June. By the end of July, Pharmaniaga Bhd, which is the exclusive distributor and also local fill-and-finish manufacturer for Sinovac’s Covid-19 vaccine will complete delivery of the entire federal government order of 12 million doses (comprising more than 5 million doses of the local fill-and-finish product and close to 7 million of the finished vaccine from Sinovac’s manufacturing site in Beijing, China).

The minister in charge of the National Covid-19 Immunisation Programme Khairy Jamaluddin has announced that in the third quarter of the year Malaysia is expected to receive 25.6 million doses of the Pfizer vaccine. It is crucial that the government ensures the availability of vaccines at all times to avoid bottlenecks and opportunities for the virus to rear its ugly head again.

At the same time, in the light of what has been happening in the purchase of vaccines, we have to be wary of the richer western countries resorting to hoarding vaccines, or having vaccines in excess of their needs. In Venezuela, for instance, there are attempts to block the vaccines from reaching the country because of US sanctions, though the country has the money to pay. Such selfish, cruel and inhumane acts jeopardise the chances of millions of Venezuelans from getting vaccinated. It’s also speculated that the display of vaccine nationalism among China, Russia, the US and Europe is a new form of power play reminiscent of the Cold War, which most likely will affect smaller and less developed countries in their quest for badly needed vaccines. Such a situation will stymie the efforts of many poor countries to keep the coronavirus at bay. Times like these call for international solidarity to face an existential threat to human life as we know it.

Finally, a point of very, very special importance is to ensure that all matters and actions designed to end this scourge are based on sound medical and scientific knowledge and principles. Nothing short of this will be acceptable. Similarly, matters regarding vaccines and the whole process of vaccination must be the decisions of medical professionals and scientists. Politicians and businessmen should have no role in these matters if we want to end the pandemic as soon as possible.

Banoo V